Feasibility of Teaching Emergency Department Nurses to Determine Fetal Heart Rates Using Bedside Ultrasound Versus the Hand-Held Doppler.

The current nursing standard for assessment of injured pregnant patients ≥12 weeks presenting to the emergency department (ED) includes obtaining an auditory fetal heart rate (FHR) measurement using a handheld Doppler (HHD). If the audible lower maternal heart rate is mistakenly determined as the FH...

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Publicado en:Journal of Radiology Nursing Vol. 42; no. 4; pp. 431 - 440
Autores principales: Miles, Gayla, Newcomb, Patricia, Spear, Dave
Formato: research Journal Article
Publicado: Elsevier B.V. Dec2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2023
      vid: 42
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      pub: Elsevier B.V.
      place: New York, New York
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        174103882
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        10.1016/j.jradnu.2023.07.003
        174103882
      ppf: 431
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        atl: Feasibility of Teaching Emergency Department Nurses to Determine Fetal Heart Rates Using Bedside Ultrasound Versus the Hand-Held Doppler.
      aug:
        au:
          Miles, Gayla
          Newcomb, Patricia
          Spear, Dave
        affil: Trauma Research, Texas Health Harris Methodist Ft. Worth Hospital, Ft. Worth, TX
      sug:
        subj:
          Wounds and Injuries Nursing
          Heart Rate, Fetal Evaluation
          Fetal Heart Ultrasonography
          Point-of-Care Testing Methods
          Point-of-Care Testing Education
          Emergency Nurses Education
          Outcomes of Education Evaluation
          Ultrasonography, Doppler Equipment and Supplies
          Competency Assessment
          Human
          Pregnancy
          Female
          Expectant Mothers
          Pilot Studies
          Simulations
          Clinical Supervision
          Nursing Assessment
          Auscultation
          Nursing Skills
          Nurse Attitudes
          Female
      ab: The current nursing standard for assessment of injured pregnant patients ≥12 weeks presenting to the emergency department (ED) includes obtaining an auditory fetal heart rate (FHR) measurement using a handheld Doppler (HHD). If the audible lower maternal heart rate is mistakenly determined as the FHR, the misidentified rate can cause false concern for fetal distress. A feasibility study was performed to investigate if nurses could accurately determine FHRs using point-of-care ultrasound (POCUS). Nurses completed a self-paced learning module along with 2-hour hands-on simulation to determine FHRs using POCUS. Competency achievement was determined by ED physician clinical supervision on pregnant patients ≥8 weeks presenting to the ED between May 9 to November 29, 2022. Eight of 11 nurses achieved competency. The participants had mixed reviews on using POCUS but favored POCUS over the HHD for reliability of locating and determining the FHR. • Intermittent auscultation of fetal heart tones by emergency department nurses on pregnant patients 12 weeks or greater can be time consuming. • Differentiating between the maternal and fetal heart rate can be difficult at times using a handheld Doppler. • Teaching nurses to use point-of-care-ultrasound to locate the gestational sac and determine the fetal heart rate can increase the accuracy of identifying the fetal heart rate correctly. • Nurses favored point-of-care-ultrasound over the handheld Doppler as being more accurate to locate and determine the fetal heart rate. • Nurses viewed having a background using ultrasound to place peripheral IVs as beneficial to learning the skill.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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